Background. The safety of wide local excision as a standard surgical option for early stage breast cancer management in Ghana has not been evaluated. The aim of this study was to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins in wide local excision specimens and offer recommendations. Study design. We reviewed 147 breast lumps; following wide local excision; which were received in the Department of Pathology; for positive tumor margins. The data was analyzed using SPSS software (version 16). Results. A total of 2;751 female breast cancers were diagnosed during the study period; of which 147 (5.3%) were from wide local excisions (lumpectomies). Thirty-one (21.0%) had positive tumor margins. The mean age of women with positive margins was 53.4 (SD = 17.1) years. The mean size of primary tumor was 4.0 (SD = 2.1) cm; the majority (53.0%) of which were greater than 2.0?cm; but less than or equal to 5.0?cm (T2). A total of 26 (83.4%) of these tumors were invasive ductal carcinomas (NOS); 24 (92.3%) of the cases had combined Bloom-Richardson grading; and many; 10 (41.7%); were grade 1. Conclusion. Our study shows that 21.0% of all wide local excision biopsies had positive tumor margins; a figure that is comparable to those of other studies. Tumors with positive margins in this study were large; 4.0?cm (T2); and common in relatively young women. Treatment failure is therefore likely to occur in these patients.

Background. The safety of wide local excision as a standard surgical option for early stage breast cancer management in Ghana has not been evaluated. The aim of this study was to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins in wide local excision specimens and offer recommendations. Study design. We reviewed 147 breast lumps; following wide local excision; which were received in the Department of Pathology; for positive tumor margins. The data was analyzed using SPSS software (version 16). Results. A total of 2;751 female breast cancers were diagnosed during the study period; of which 147 (5.3%) were from wide local excisions (lumpectomies). Thirty-one (21.0%) had positive tumor margins. The mean age of women with positive margins was 53.4 (SD = 17.1) years. The mean size of primary tumor was 4.0 (SD = 2.1) cm; the majority (53.0%) of which were greater than 2.0?cm; but less than or equal to 5.0?cm (T2). A total of 26 (83.4%) of these tumors were invasive ductal carcinomas (NOS); 24 (92.3%) of the cases had combined Bloom-Richardson grading; and many; 10 (41.7%); were grade 1. Conclusion. Our study shows that 21.0% of all wide local excision biopsies had positive tumor margins; a figure that is comparable to those of other studies. Tumors with positive margins in this study were large; 4.0?cm (T2); and common in relatively young women. Treatment failure is therefore likely to occur in these patients.

A total of 362 diabetics were admitted over a 7-year period (January 1995 to December 2002) to a Nigerian tertiary hospital. Forty (40) of these (8.8%) died as in-patients. Twenty-six (26) were male and 14 were female. Thirteen (32%) were newly diagnosed with diabetes. Seventy percent (70%) of deaths occurred within 1 week of admission. A case-controlled study of the diabetic deaths revealed that presentation with any of the following were associated with in-patient death: diabetic emergencies (p<0.001), infective process (p<0.001), fever (p<0.001), systolic hypertension (p=0.001), and short duration of hospitalisation (p=0.001). It is suggested that greater awareness of diabetes and education of newly diagnosed cases may reduce this high mortality. In addition, the national health insurance system should cover all disease care, including diabetes

A total of 362 diabetics were admitted over a 7-year period (January 1995 to December 2002) to a Nigerian tertiary hospital. Forty (40) of these (8.8%) died as in-patients. Twenty-six (26) were male and 14 were female. Thirteen (32%) were newly diagnosed with diabetes. Seventy percent (70%) of deaths occurred within 1 week of admission. A case-controlled study of the diabetic deaths revealed that presentation with any of the following were associated with in-patient death: diabetic emergencies (p<0.001), infective process (p<0.001), fever (p<0.001), systolic hypertension (p=0.001), and short duration of hospitalisation (p=0.001). It is suggested that greater awareness of diabetes and education of newly diagnosed cases may reduce this high mortality. In addition, the national health insurance system should cover all disease care, including diabetes

Objective: Medically unexplained symptoms (MUS) are commonly encountered in medical practice. In psychiatry; they are classified mostly as Somatoform Disorders and are often associated with anxiety and depression. The literature suggests that; in some cases; MUS may be ascribed to Somatoform Disorders when; fact; they are ""organic"" syndromes that are misdiagnosed. In developing countries; with fewer resources; MUS may be more difficult to assess. Method: We undertook a retrospective chart review to examine the demographics; referral pathway; management and diagnostic outcome of subjects (n = 50) referred to psychiatry with MUS over an 18 month period. Results: Subjects with MUS accounted for only 4.5of the total number of files reviewed. In only 38of cases did the final diagnosis in psychiatry concur with the referral diagnosis. In 28of cases a new ''organic"" diagnosis was made and in 72of cases a new psychiatric diagnosis was made. Subjects who were diagnosed with ""organic"" illness were seen fewer times prior to referral to psychiatry and were significantly older than other subjects. Conclusion: In developing countries like SA; a significant number of patients with MUS may have underlying ""organic"" illness; and most may have psychiatric disorders. Patients with MUS; especially older patients; should be more extensively investigated. Psychiatric referral of these patients is very appropriate."

Objective: Medically unexplained symptoms (MUS) are commonly encountered in medical practice. In psychiatry; they are classified mostly as Somatoform Disorders and are often associated with anxiety and depression. The literature suggests that; in some cases; MUS may be ascribed to Somatoform Disorders when; fact; they are ""organic"" syndromes that are misdiagnosed. In developing countries; with fewer resources; MUS may be more difficult to assess. Method: We undertook a retrospective chart review to examine the demographics; referral pathway; management and diagnostic outcome of subjects (n = 50) referred to psychiatry with MUS over an 18 month period. Results: Subjects with MUS accounted for only 4.5of the total number of files reviewed. In only 38of cases did the final diagnosis in psychiatry concur with the referral diagnosis. In 28of cases a new ''organic"" diagnosis was made and in 72of cases a new psychiatric diagnosis was made. Subjects who were diagnosed with ""organic"" illness were seen fewer times prior to referral to psychiatry and were significantly older than other subjects. Conclusion: In developing countries like SA; a significant number of patients with MUS may have underlying ""organic"" illness; and most may have psychiatric disorders. Patients with MUS; especially older patients; should be more extensively investigated. Psychiatric referral of these patients is very appropriate."

Introduction: The risk of drug-drug interactions (DDIs) is high in patients with chronic kidney disease (CKD) necessitating dose adjustments or the avoidance of drug combinations. This study aimed to evaluate DDIs among patients with CKD in the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.Methods: this study was a retrospective review of patients with CKD who received treatment at the nephrology unit of UNTH between January 2004 and December 2014. The drug-drug interactions (DDIs) of the prescribed drugs were classified using the RxList interaction checker. The IBM SPSS Version 21.0 was utilized for statistical analysis with P-value ≤ 0.05, considered statistically significant.Results: a total of 749 DDIs were identified from the folders of the 169 patients with CKD that were eligible. Majority were above 50 years old and in stage 4 or 5 CKD. Furosemide,lisinopril and amlodipine were the most frequently prescribed drugs and had the greatest likelihood for nephrotoxicity. The number of medications and hypertension (as co-morbidity) were significant and independent predictors of DDIs among the patients. About 70% of the drug combinations required monitoring as they fell within the “significant category” of the RxList interaction checker. The most common interactions were between lisinopril and furosemide; furosemide and calcium carbonate; lisinopril and calcium carbonate.Conclusion: the prevalence of DDIs was high among the CKD patients. Prescribers and pharmacists in Nigerian hospitals may need to pay close attention to prescriptions of patients with CKD to identify, prevent and resolve undesirable DDIs.

Introduction: The risk of drug-drug interactions (DDIs) is high in patients with chronic kidney disease (CKD) necessitating dose adjustments or the avoidance of drug combinations. This study aimed to evaluate DDIs among patients with CKD in the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.Methods: this study was a retrospective review of patients with CKD who received treatment at the nephrology unit of UNTH between January 2004 and December 2014. The drug-drug interactions (DDIs) of the prescribed drugs were classified using the RxList interaction checker. The IBM SPSS Version 21.0 was utilized for statistical analysis with P-value ≤ 0.05, considered statistically significant.Results: a total of 749 DDIs were identified from the folders of the 169 patients with CKD that were eligible. Majority were above 50 years old and in stage 4 or 5 CKD. Furosemide,lisinopril and amlodipine were the most frequently prescribed drugs and had the greatest likelihood for nephrotoxicity. The number of medications and hypertension (as co-morbidity) were significant and independent predictors of DDIs among the patients. About 70% of the drug combinations required monitoring as they fell within the “significant category” of the RxList interaction checker. The most common interactions were between lisinopril and furosemide; furosemide and calcium carbonate; lisinopril and calcium carbonate.Conclusion: the prevalence of DDIs was high among the CKD patients. Prescribers and pharmacists in Nigerian hospitals may need to pay close attention to prescriptions of patients with CKD to identify, prevent and resolve undesirable DDIs.

The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore; aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic; psychiatry diagnosis and length of stay on admission. Method: In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi; between January; 2004 and December; 2008 were studied for gender differences regarding demographic attributes; length of stay and psychiatry diagnoses. Results: Findings revealed that more men than women were admitted overall. Most men (56) were less than 30 years old whereas 60.6of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5); followed by substance related disorders (16.5) then depression (14.0); for women the main diagnosis was also schizophrenia (30.3); this was followed by depression (24.5); only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p=0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p=0.161). Conclusion: The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation; it is imperative to pay attention to gender issues that may affect the development of psychopathology

The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore; aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic; psychiatry diagnosis and length of stay on admission. Method: In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi; between January; 2004 and December; 2008 were studied for gender differences regarding demographic attributes; length of stay and psychiatry diagnoses. Results: Findings revealed that more men than women were admitted overall. Most men (56) were less than 30 years old whereas 60.6of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5); followed by substance related disorders (16.5) then depression (14.0); for women the main diagnosis was also schizophrenia (30.3); this was followed by depression (24.5); only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p=0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p=0.161). Conclusion: The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation; it is imperative to pay attention to gender issues that may affect the development of psychopathology